Carotid artery stent placement for carotid stenosis
Summary
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on carotid artery stent placement for carotid stenosis.
Description
Stroke secondary to carotid stenosis occurs when a major portion of one or both carotid arteries (the arteries in the neck that supply blood to the brain) is narrowed or blocked. Carotid stenosis increases the risk of ischemic stroke by acting as an embolic source.
Carotid endarterectomy has been the standard treatment for patients with symptomatic stenosis. The procedure involves making an incision in the neck. The artery is then opened and the plaque removed.
Carotid stenting is a less invasive percutaneous procedure than carotid endarterectomy for the treatment of carotid stenosis. Carotid stenting is carried out under local anaesthetic and involves passing a fine wire into the carotid artery through the femoral artery in the groin. A small balloon catheter may be passed over this to pre-dilate the narrowed artery before inserting a metal mesh (stent) which keeps the artery open to maintain blood flow and to prevent recurrence of stenosis. A cerebral protection device may also be used in this procedure
OPCS code:
L31.4 Percutaneous transluminal insertion of stent into carotid artery
Note: Use a supplementary code for placement of stent (L76, L89, O20)
A code from category L76.- Endovascular placement of stent or L89.- Other endovascular placement of stent or O20.- Endovascular placement of stent graft is added to specify the type and number of stents used.
Y53.- Approach to organ under image control
Note: Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
Details
Central nervous system
Surgical procedures
Contact details:
(for general enquiries or comments)
(for procedure specific enquiries or comments)
ip@nice.org.uk
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
